Physiotherapy practice in the private sector: organizational characteristics and models.

BACKGROUND: Even if a large proportion of physiotherapists work in the private sector worldwide, very little is known of the organizations within which they practice. Such knowledge is important to help understand contexts of practice and how they influence the quality of services and patient outcomes. The purpose of this study was to: 1) describe characteristics of organizations where physiotherapists practice in the private sector, and 2) explore the existence of a taxonomy of organizational models. METHODS: This was a cross-sectional quantitative survey of 236 randomly-selected physiotherapists. Participants completed a purpose-designed questionnaire online or by telephone, covering organizational vision, resources, structures and practices. Organizational characteristics were analyzed descriptively, while organizational models were identified by multiple correspondence analyses. RESULTS: Most organizations were for-profit (93.2%), located in urban areas (91.5%), and within buildings containing multiple businesses/organizations (76.7%). The majority included multiple providers (89.8%) from diverse professions, mainly physiotherapy assistants (68.7%), massage therapists (67.3%) and osteopaths (50.2%). Four organizational models were identified: 1) solo practice, 2) middle-scale multiprovider, 3) large-scale multiprovider and 4) mixed. CONCLUSIONS: The results of this study provide a detailed description of the organizations where physiotherapists practice, and highlight the importance of human resources in differentiating organizational models. Further research examining the influences of these organizational characteristics and models on outcomes such as physiotherapists' professional practices and patient outcomes are needed.

Everyday Ethics: Framing youth participation in organizational practice

Much of the literature on ethical issues in child and youth participation has drawn on the episodic experiences of participatory research efforts in which young people’s input has been sought, transcribed and represented. This literature focuses in particular on the power dynamics and ethical dilemmas embedded in time-bound adult/child and outsider/insider relationships. While we agree that these issues are crucial and in need of further examination, it is equally important to examine the ethical issues embedded within the “everyday” practices of the organizations in and through which young people’s participation in community research and development often occurs (e.g., community-based organizations, schools and municipal agencies). Drawing on experience from three summers of work in promoting youth participation in adult-led organizations of varying purpose, scale and structure, a framework is postulated that presents participation as a spatial practice shaped by five overlapping dimensions. The framework is offered as a point of discussion and a potential tool for analysis in ecipation in relation to organizational practice.

What are the components of humanized childbirth in a highly specialized hospital? : an organizational case study

Many studies have focused on the concept of humanization of birth in normal pregnancy cases or at low obstetric risk, but no studies, at our knowledge, have so far specifically focused on the humanization of birth in both high-risk, and low risk pregnancies, in a highly specialized hospital setting. The present study thus aims to: 1) define the specific components of the humanized birth care model which bring satisfaction to women who seek obstetrical care in highly specialized hospitals; and 2) explore the organizational and cultural dimensions which act as barriers or facilitators for the implementation of humanized birth care practices in a highly specialized, university affiliated hospital in Quebec. A single case study design was chosen for this thesis. The data were collected through semi-structured interviews, field notes, participant observations, selfadministered questionnaire, relevant documents, and archives. The samples comprised: 11 professionals from different disciplines, 6 administrators from different hierarchical levels within the hospital, and 157 women who had given birth at the hospital during the study. The performed analysis covered both quantitative descriptive and qualitative deductive and inductive content analyses. The thesis comprises three articles. In the first article, we proposed a conceptual framework, based on Allaire and Firsirotu’s (1984) organizational culture theory. It attempts to examine childbirth patterns as an organizational cultural phenomenon. In our second article, we answered the following specific question: according to the managers and multidisciplinary professionals practicing in a highly specialized hospital as well as the women seeking perinatal care in this hospital setting, what is the definition of humanized care? Analysis of the data collected uncovered the following themes which explained the perceptions of what humanized birth was: personalized care, recognition of women’s rights, humanly care for women, family-centered care,women’s advocacy and companionship, compromise of security, comfort and humanity, and non-stereotyped pregnancies. Both high and low risk women felt more satisfied with the care they received if they were provided with informed choices, were given the right to participate in the decision-making process and were surrounded by competent care providers. These care providers who humanly cared for them were also able to provide relevant medical intervention. The professionals and administrators’ perceptions of humanized birth, on the other hand, mostly focused on personalized and family-centered care. In the third article of the thesis, we covered the dimensions of the internal and external components of an institution which can act as factors that facilitate or barriers that prevent, a specialized and university affiliated hospital in Quebec from adopting a humanized child birthing care. The findings revealed that both the external dimensions of a highly specialized hospital -including its history, society, and contingency-; and its internal dimensions -including culture, structure, and the individuals present in the hospital-, can all affect the humanization of birth care in such an institution, whether separately, simultaneously or in interaction. We thus hereby conclude that the humanization of birth care in a highly specialized hospital setting, should aim to meet all the physiological, as well as psychological aspects of birth care, including respect of the fears, beliefs, values, and needs of women and their families. Integration of competent and caring professionals and the use of obstetric technology to enhance the level of certainty and assurance in both high-risk and low risk women are both positive factors for the implementation of humanized care in a highly specialized hospital. Finally, the humanization of birth care approach in a highly specialized and university affiliated hospital setting demands a new healthcare policy. Such policy must offer a guarantee for women to have the place of birth, and the health care professional of their choice as well as those, which will enable women to make informed choices from the beginning of their pregnancy.

Contemporary organizational theory in the management of construction projects

The level of insolvencies in the construction industry is high, when compared to other industry sectors. Given the management expertise and experience that is available to the construction industry, it seems strange that, according to the literature, the major causes of failure are lack of financial control and poor management. This indicates that with a good cash flow management, companies could be kept operating and financially healthy. It is possible to prevent failure. Although there are financial models that can be used to predict failure, they are based on company accounts, which have been shown to be an unreliable source of data. There are models available for cash flow management and forecasting and these could be used as a starting point for managers in rethinking their cash flow management practices. The research reported here has reached the stage of formulating researchable questions for an in-depth study including issues such as how contractors manage their cash flow, how payment practices can be managed without damaging others in the supply chain and the relationships between companies" financial structures and the payment regimes to which they are subjected.

Relational pluralism: organizational foresight in practice

This paper examines organizational foresight from a relational perspective. In doing this, we present relational incumbency as a transient conceptual framework to explore how the organizing social relationships and interactions of lower participants may influence organizational foresightfulness. The research employed an exploratory case-based approach with three software organisations and their four new product innovation projects serving as the empirical research sites. Drawing on the case evidence, we provide an account on how normative organizing structures, rights and authority relationships constitutively influence the creative emergence of organizational foresight in practice. We conclude the paper with a discussion of the managerial implications and some directions for future research.

Organizational design and incentive provision

We model the trade-off between the balance and the strength of incentives implicit in the choice between hierarchical and matrix or- ganizational structures. We show that managerial biases determine which structure is optimal: hierarchical forms are preferred when biases are low, while matrix structures are preferred when biases are high. Moreover, the results show that there is always a level of bias for which matrix design can achieve the expected profit obtained by shareholders if they could directly control the firm. We also show that the main trade-off, i.e., hierarchical versus matrix structure is preserved under asymmetric levels of bias among managers and when low-level workers perceive activities with complementary efforts.

The art of being together: a social constructionist perspective on dialogic methods in the organizational context

The purpose of this project is to understand, under a social constructionist approach, what are the meanings that external facilitators and organizational members (sponsors) working with dialogic methods place on themselves and their work. Dialogic methods, with the objective of engaging groups in flows of conversations to envisage and co-create their own future, are growing fast within organizations as a means to achieve collective change. Sharing constructionist ideas about the possibility of multiple realities and language as constitutive of such realities, dialogue has turned into a promising way for transformation, especially in a macro context of constant change and increasing complexity, where traditional structures, relationships and forms of work are questioned. Research on the topic has mostly focused on specific methods or applications, with few attempts to study it in a broader sense. Also, despite the fact that dialogic methods work on the assumption that realities are socially constructed, few studies approach the topic from a social constructionist perspective, as a research methodology per se. Thus, while most existing research aims at explaining whether or how particular methods meet particular results, my intention is to explore the meanings sustaining these new forms of organizational practice. Data was collected through semi-structured interviews with 25 people working with dialogic methods: 11 facilitators and 14 sponsors, from 8 different organizations in Brazil. Firstly, the research findings indicate several contextual elements that seem to sustain the choices for dialogic methods. Within this context, there does not seem to be a clear or specific demand for dialogic methods, but a set of different motivations, objectives and focuses, bringing about several contrasts in the way participants name, describe and explain their experiences with such methods, including tensions on power relations, knowledge creation, identity and communication. Secondly, some central ideas or images were identified within such contrasts, pointing at both directions: dialogic methods as opportunities for the creation of new organizational realities (with images of a ‘door’ or a ‘flow’, for instance, which suggest that dialogic methods may open up the access to other perspectives and the creation of new realities); and dialogic methods as new instrumental mechanisms that seem to reproduce the traditional and non-dialogical forms of work and relationship. The individualistic tradition and its tendency for rational schematism - pointed out by social constructionist scholars as strong traditions in our Western Culture - could be observed in some participants’ accounts with the image of dialogic methods as a ‘gym’, for instance, in which dialogical – and idealized –‘abilities’ could be taught and trained, turning dialogue into a tool, rather than a means for transformation. As a conclusion, I discuss what the implications of such taken-for-granted assumptions may be, and offer some insights into dialogue (and dialogic methods) as ‘the art of being together’.

Relationship between composition and organizational levels of nanostructured systems formed by Oleth 10 and PPG-5-Ceteth-20 for potential drug delivery

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Identity dynamics and the emergence of new organizational arrangements: A multi-level study

Organizational and institutional scholars have advocated the need to examine how processes originating at an individual level can change organizations or even create new organizational arrangements able to affect institutional dynamics (Chreim et al., 2007; Powell & Colyvas, 2008; Smets et al., 2012). Conversely, research on identity work has mainly investigated the different ways individuals can modify the boundaries of their work in actual occupations, thus paying particular attention to ‘internal’ self-crafting (e.g. Wrzesniewski & Dutton, 2001). Drawing from literatures on possible and alternative self and on positive organizational scholarship (e.g., Obodaru, 2012; Roberts & Dutton, 2009), my argument is that individuals’ identity work can go well beyond the boundaries of internal self-crafting to the creation of new organizational arrangements. In this contribution I analyze, through multiple case studies, healthcare professionals who spontaneously participated in the creation of new organizational arrangements, namely health structures called Community Hospitals. The contribution develops this form of identity work by building a grounded model. My findings disclose the process that leads from the search for the enactment of different self-concepts to positive identities, through the creation of a new organizational arrangement. I contend that this is a particularly complex form of collective identity work because it requires, to be successful, concerted actions of several internal, external and institutional actors, and it also requires balanced tensions that – at the same time - enable individuals’ aspirations and organizational equilibrium. I name this process organizational collective crafting. Moreover I inquire the role of context in supporting the triggering power of those unrealized selves. I contribute to the comprehension of the consequences of self-comparisons, organizational identity variance, and positive identity. The study bears important insights on how identity work originating from individuals can influence organizational outcomes and larger social systems.

NEMAWASHI: Attaining Value Stream alignment within Complex Organizational Networks

In the process of value creation, organizations perform an intense intra-organizational dialog through which internal VS alignment is achieved towards certain strategic objectives. Within the context of complex organizational networks, were goal conflicts are preprogrammed through incentive structures, VS alignment as legitimation of action towards strategic goals has special interest. On the one hand it facilitates the access to necessary resources for goal achievement and on the other it increases the sustainability and supports commonly agreed upon decisions leading to success. This paper provides a winnerless process (WLP) differential equations model for quantifying intra-organizational value stream (VS) alignment dynamics that can help design sustainable lean management solutions. This paper presents ongoing research results that show how the model was implemented in one industrial facility.

International handbook of organizational teamwork and cooperative working

In today's fast changing, hyper–competitive environment, teamwork and co–operative working enhance the organisation's adaptive capability. The team, rather than the individual, is increasingly seen as the building block of organisations and a key source of competitive advantage. The International Handbook of Organisational Teamwork and Co–operative Working provides a clear focus on the psychological and social processes that can stimulate successful cooperation and teamwork. Michael West, Dean Tjosvold and Ken Smith have brought together the world's leading authorities from a range of social science disciplines to provide a contemporary review of established and emerging perspectives. Throughout the book, processes that both facilitate and obstruct successful cooperation and teamwork are detailed, alongside guidance on best practice and methodology. The challenging and alternative perspectives presented will inform future research and practice. The result is a systematic and comprehensive synthesis of knowledge from a range of disciplines that will prove invaluable to professionals, researchers and students alike. * A systematic and coherent framework which organizes and structures the knowledge in this field * An outstanding collection of authoritative "high profile" authors * Challenging, alternative perspectives that will stimulate and enlighten future research and practice * Selective, updated bibliographies of key literatures support every chapter, a valuable resource for students, trainers and practitioners

Strategic orientations in practice:Exploring the strategic belief structures of line-managers embedded in practice

Recently researchers have started to investigate the cognitive strategic orientations of individual top managers and have pointed out these may be key in determining the direction and success of their organizations in terms of performance, but they have been unable to effectively operationalize this notion in empirical research and this is holding up knowledge development. To make a contribution that helps overcome this limitation a theoretical framework is developed which specifies the different possible cognitive strategic orientations of top managers as well as those of managers at lower organizational levels involved in the strategy process. This theoretical framework is investigated in the empirical phase of the study into strategic orientations in practice. Additional contributions to knowledge of strategic orientation are made in three main domains. Firstly, current knowledge of strategic orientation is largely limited to analysis at the level of the firm whereas there is a lack of understanding of any relationships with practice at lower organizational levels. The exploratory research undertaken for this thesis contributes to new knowledge of different rational, developmental and interactive strategic orientations of front-line managers and this contributes to a cognitive explanation for emergent strategy linked to strategy processes embedded in practice. In theorising the presence of different strategic orientations in practice the discussion highlights the importance of network and spatial embeddedness within enacted environments. Secondly, a contribution to further knowledge of the links between strategy processes and the content of strategies within a retail context is made. The research highlights different strategy processes used in practice by retail front-line managers in a branch network of stores and these are linked to consequences such as different objectives, performance expectations and the fulfilment of personal goals. Thirdly, a contribution to research methodology is made by addressing problems associated with the comparison of cognitive maps.

The variance in sales performance explained by the knowledge structures of salespeople

The last major study of sales performance variance explained by salespeople attributes was by Churchill et al. (1985). They examined the effect of role, skills, motivation, personal factors, aptitude, and organizational/environmental factors on sales performance—factors that have dominated the sales performance area. About the same time, Weitz, Sujan, and Sujan (1986) introduced the concepts of salespeople's knowledge structures. Considerable work on the relationship of the elements of knowledge structures and performance can be found in the literature. In this research note, we determine the degree to which sales performance can be explained by knowledge structure variables, a heretofore unexplored area. If knowledge structure variables explain more variance than traditional variables, then this paper would be a call to further research in this area. In examining this research question in a retail context, we find that knowledge structure variables explain 50.2 percent of the variance in sales performance. We also find that variance explained by knowledge structures is significantly different based on gender. The impact of knowledge structures on performance was higher for men than for women. The models using education demonstrated smaller differences.

Research strategies for organizational history:a dialogue between historical theory and organization theory

If history matters for organization theory, then we need greater reflexivity regarding the epistemological problem of representing the past; otherwise, history might be seen as merely a repository of ready-made data. To facilitate this reflexivity, we set out three epistemological dualisms derived from historical theory to explain the relationship between history and organization theory: (1) in the dualism of explanation, historians are preoccupied with narrative construction, whereas organization theorists subordinate narrative to analysis; (2) in the dualism of evidence, historians use verifiable documentary sources, whereas organization theorists prefer constructed data; and (3) in the dualism of temporality, historians construct their own periodization, whereas organization theorists treat time as constant for chronology. These three dualisms underpin our explication of four alternative research strategies for organizational history: corporate history, consisting of a holistic, objectivist narrative of a corporate entity; analytically structured history, narrating theoretically conceptualized structures and events; serial history, using replicable techniques to analyze repeatable facts; and ethnographic history, reading documentary sources "against the grain." Ultimately, we argue that our epistemological dualisms will enable organization theorists to justify their theoretical stance in relation to a range of strategies in organizational history, including narratives constructed from documentary sources found in organizational archives. Copyright of the Academy of Management, all rights reserved.

Using ORG-Master for Knowledge Based Organizational Change

* Under Knowledge Infrastructure we imply all the means that enable effective knowledge management within organization ~ knowledge process support.